Demographics and Inclusivity in CDI Survey

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2. Please indicate the race/ethnicity with which you identify (check all that apply): (Required.)

African American/Black

East Asian

Hispanic/Latino

Middle Eastern

American Indian/Alaskan Native

Pacific Islander

South Asian

Caucasian/White

Other (please specify)

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3. Please indicate the gender with which you identify. (Required.)

Cisgender woman

Cisgender man

Transgender woman

Transgender man

Non-binary

Prefer not to answer

Other (please specify)

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4. Please indicate the sexual orientation with which you identify. (Required.)

Heterosexual

Gay/Lesbian

Bisexual

Pansexual

Asexual

Prefer not to answer

Other (please specify)

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5. In what region of the country do you work? (Required.)

Northeast (CT, MA, ME, NH, NY, RI, VT)

North central (IA, IL, IN, MI, MN, NE, ND, OH, SD, WI)

West (AZ, CO, ID, MT, NM, NV, UT, WY)

Middle Atlantic (DE, MD, NJ, PA, DC)

Southeast (AL, FL, GA, KY, MS, NC, SC, TN, VA, WV)

South Central (AR, KS, LA, MO, OK, TX)

Pacific (AK, CA, HI, OR, WA)

Other (please specify if outside U.S.)

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6. What is your perception of ACDIS as an organization, with regard to racial diversity?

Diverse/no concerns

Neutral

Non-diverse/needs improvement

Not sure

Other (please specify)

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7. What is your perception of the CDI profession, with regard to racial diversity?

Diverse/no concerns

Neutral

Non-diverse/needs improvement

Not sure

Other (please specify)

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8. What is your perception of ACDIS as an organization and its values of racial diversity?

Welcoming/no concerns

Neutral

Needs improvement (please add your suggestion below)

Not sure

If you checked "needs improvement" please specify

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9. What is your perception of CDI as a profession and its values of racial diversity?

Welcoming/no concerns

Neutral

Needs improvement (please add your suggestion below)

Not sure

If you checked "needs improvement" please specify

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10. How diverse is the organization in which you work?

Very diverse

Somewhat diverse

Not diverse

Not sure

Other (please specify)

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11. How diverse is the CDI department in which you work?

Very diverse

Somewhat diverse

Not diverse

Not sure

Other (please specify)

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12. How active is the organization in which you work in promoting diversity and inclusion?

Very active

Somewhat active

Not active

Not sure

Other (please specify)

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13. Do you identify as being in a racial minority?

Yes

Not sure

Other (please specify)

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14. How well do you feel your race/ethnicity is represented by ACDIS as an organization?

Very well represented

Somewhat represented

Neutral

Not well represented

Other (please specify)

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15. How well do you feel your race/ethnicity is represented in CDI as a profession?

Very well represented

Somewhat represented

Neutral

Not well represented

Other (please specify)

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16. Have you experienced racial/ethnic bias in your CDI career?

Yes

Not sure

Please describe if yes

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17. Do you believe that racial/ethnic bias has hindered your CDI career?

Yes

Not sure

Please describe if yes

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18. Have you experienced racial/ethnic bias, at an ACDIS event or program?

Yes (please elaborate below)

Not sure

Please elaborate if yes

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19. Did you immigrate to the United States?

Yes

Prefer not to answer

Other (please specify)

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20. What steps would you recommend ACDIS take to ensure it is racially/ethnically diverse and welcoming?

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21. Are you willing to share your personal story as a person of color in an ACDIS publication (Journal article, ACDIS Podcast, or other)?

Yes

If yes, please provide any details.

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22. If you answered yes to the previous question, or if you would like, please provide your contact information (this is optional and you may remain anonymous if preferred, or place "N/A" in any fields you do not wish to include).

Name

Organization name

Title

Email Address

Phone Number

Demographics and Inclusivity in CDI

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* 1. Please indicate your title/role (check all that apply): (Required.)

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* 2. Please indicate the race/ethnicity with which you identify (check all that apply): (Required.)

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* 3. Please indicate the gender with which you identify. (Required.)

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* 4. Please indicate the sexual orientation with which you identify. (Required.)

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* 5. In what region of the country do you work? (Required.)

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* 6. What is your perception of ACDIS as an organization, with regard to racial diversity?

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* 7. What is your perception of the CDI profession, with regard to racial diversity?

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* 8. What is your perception of ACDIS as an organization and its values of racial diversity?

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* 9. What is your perception of CDI as a profession and its values of racial diversity?

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* 10. How diverse is the organization in which you work?

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* 11. How diverse is the CDI department in which you work?

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* 12. How active is the organization in which you work in promoting diversity and inclusion?

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* 13. Do you identify as being in a racial minority?

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* 14. How well do you feel your race/ethnicity is represented by ACDIS as an organization?

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* 15. How well do you feel your race/ethnicity is represented in CDI as a profession?

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* 16. Have you experienced racial/ethnic bias in your CDI career?

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* 17. Do you believe that racial/ethnic bias has hindered your CDI career?

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* 18. Have you experienced racial/ethnic bias, at an ACDIS event or program?

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* 19. Did you immigrate to the United States?

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* 20. What steps would you recommend ACDIS take to ensure it is racially/ethnically diverse and welcoming?

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* 21. Are you willing to share your personal story as a person of color in an ACDIS publication (Journal article, ACDIS Podcast, or other)?

Question Title

* 22. If you answered yes to the previous question, or if you would like, please provide your contact information (this is optional and you may remain anonymous if preferred, or place "N/A" in any fields you do not wish to include).

1. Please indicate your title/role (check all that apply): (Required.)

2. Please indicate the race/ethnicity with which you identify (check all that apply): (Required.)

3. Please indicate the gender with which you identify. (Required.)

4. Please indicate the sexual orientation with which you identify. (Required.)

5. In what region of the country do you work? (Required.)

6. What is your perception of ACDIS as an organization, with regard to racial diversity?

7. What is your perception of the CDI profession, with regard to racial diversity?

8. What is your perception of ACDIS as an organization and its values of racial diversity?

9. What is your perception of CDI as a profession and its values of racial diversity?

10. How diverse is the organization in which you work?

11. How diverse is the CDI department in which you work?

12. How active is the organization in which you work in promoting diversity and inclusion?

13. Do you identify as being in a racial minority?

14. How well do you feel your race/ethnicity is represented by ACDIS as an organization?

15. How well do you feel your race/ethnicity is represented in CDI as a profession?

16. Have you experienced racial/ethnic bias in your CDI career?

17. Do you believe that racial/ethnic bias has hindered your CDI career?

18. Have you experienced racial/ethnic bias, at an ACDIS event or program?

19. Did you immigrate to the United States?

20. What steps would you recommend ACDIS take to ensure it is racially/ethnically diverse and welcoming?

21. Are you willing to share your personal story as a person of color in an ACDIS publication (Journal article, ACDIS Podcast, or other)?

22. If you answered yes to the previous question, or if you would like, please provide your contact information (this is optional and you may remain anonymous if preferred, or place "N/A" in any fields you do not wish to include).